Mifepristone and misoprostol are the two medications used for a medical abortion. These pills can either be used together, or misoprostol can be used by itself.
If you follow our blog, you’ll remember that last week our team published part one of our two-part instructional series: How To Use Misoprostol For Abortion? In today’s second installment, we’ll cover how mifepristone and misoprostol are used together.
Just like we discussed last week, these instructions are intended for pregnancies within the first 10 weeks of gestation. If you need help determining the length of a pregnancy, you can visit our website’s pregnancy calculator or read through our step-by-step calculation guide.
Make sure that you have the appropriate medication before starting the abortion. Terminating a pregnancy within the first 10 weeks requires one pill of mifepristone (200mg) and four pills of misoprostol (200mcg each).
Not sure about abortion in your country? Don’t know where you can get access to safe pills? We suggest you start by visiting our country profiles to learn more about resources near you.
Before you begin, you’ll want to find a location to have the abortion that feels safe, private, and comfortable. Cramping and bleeding are normal parts of the abortion process, so choose a location where you feel able to relax and care for yourself. Know that there are simple steps you can take before having an abortion to help minimize discomfort: we list them under our general advice section. You can also read through all of our suggested considerations here.
Opting to have an abortion at home? We wrote a whole guide that we think you’ll find useful.
Have the pills? A location? A plan? The following instructions can be used when you’re ready to begin the abortion.
Step 1: Swallow the mifepristone pill (200mg) with water.
Step 2: Wait 24-48 hours. You should wait at least 24 hours before using misoprostol, but don’t wait longer than 48 hours. You can carry on life as usual while you wait. Avoid alcohol and drug use during this time. Roughly 10% of women will experience light spotting after using mifepristone. This is normal and should not worry you.
Step 3: After you’ve waited at least 24 hours, swallow a drink of water to make your mouth moist. Place the 4 misoprostol pills inside your mouth, between your cheeks and your lower gums. Two pills go on the left side and two pills go on the right side. (You can also place all 4 pills under the tongue instead).
Step 4: Allow the pills to dissolve in place for 30 minutes. Do not eat or drink during this time. You may notice that the pills make your mouth feel dry or chalky. This is normal.
Step 5: After you’ve allowed the misoprostol to dissolve for 30 minutes in your mouth, drink a glass of water and swallow down everything that remains of the pills.
Bleeding and cramping are signs that the abortion is working. Women should expect them to begin within 3 hours of using the misoprostol.
The bleeding you experience after an abortion may be as heavy or heavier than a regular menstrual period. Bleeding can vary based on each person’s body and the length of the pregnancy. Be aware, though: bleeding that is either excessively heavy or very light are both signs of possible complication.
Excessive bleeding can be a sign of hemorrhage and needs to be treated immediately in a hospital or clinic. If you’ve soaked 2 regular menstrual pads with blood in an hour for 2 hours straight (or 4 soaked pads in 2 hours), seek emergency care. In this case, “soaking” means that the pad is completely filled with blood- front to back, side to side, and all the way through.
Little or no bleeding, on the other hand, is usually a sign that the abortion did not work. You can visit our friends at womenhelp.org, womenonweb.org or safe2choose.org who may be able to help you determine the best next steps.
Regular menstruation should return 4-6 weeks after the abortion.
If you’d like to confirm that the abortion was successful, wait at least 2 weeks before using a urine pregnancy test. These tests work by measuring pregnancy hormones in your urine. After a pregnancy is terminated, it takes the hormones a few weeks to return to their regular non-pregnant levels. If you use the pregnancy test sooner than 2 weeks, you will most likely get an inaccurate result.
Want to avoid pregnancy in the future? Know that you have a right to contraception. It’s important to remember that women can get pregnant again almost immediately after an abortion, so be sure to explore your options. We particularly like the work our friends are doing over at findmymethod.org.
If you are looking to learn more about safe medical abortion, you can visit our website or send us an email at firstname.lastname@example.org. You can also follow us on social media: we’re Facebook, Instagram, Twitter and Pinterest.
Claire is a teacher, reproductive rights advocate, and the manager of https://www.howtouseabortionpill.org/